BEUDAMED
    FDA Adverse Event Death Summary report: N

    00110203000

    MDR report key: 96890 · Received June 5, 1997

    Report

    Report Number
    1822565-1997-00067
    Event Type
    Death
    Date Received
    June 5, 1997
    Date of Event
    March 22, 1997
    Report Date
    June 4, 1997
    Manufacturer
    ZIMMER, INC.
    Product Code
    LOD
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING INSERTION OF BONE CEMENT PT EXPIRED. STAFF ORTHOPAEDIC SURGEON AND MEDICAL CORONER DO NOT FEEL THE INCIDENT WAS CEMENT RELATED. THE PT DIED FROM COMPLICATIONS RELATED TO THE PROCEDURE (MDR97-00067).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 00110203000 Implant Z BN CM LVC ROP 80/40 KIT LOD ZIMMER, INC. 3900 74157700

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Death